Professional Medicare Advisors can Help
Almost everyone over 65 will enroll in Medicare, but few people understand the impact Medicare decisions can have on retirement. Insufficient coverage or denial of legitimate claims could result in your family “inheriting” the burden of your care.
Medicare deadlines often sneak up on people without warning, leaving little time for research and evaluation to make informed decisions. Most people have no experience with Medicare planning and the enrollment process, which can make decisions feel like a shot in the dark. This year in the U.S. there are more than 3,200 Medicare Plans available across several major categories. Common misconceptions further cloud decision-making.
This article will help you elevate your Medicare IQ by debunking some popular misconceptions.
“I’m expecting to get a notice from the government telling me to enroll in Medicare.”
You don’t get a notice. It’s on you to get with the (right) program (at the right time). You’re eligible to enroll in Medicare three months before your 65th birthday, and 3 months after, plus the month of your birthday (total 7 months).
“I’ll just sign up for Medicare…”
It’s not as easy as it sounds. Medicare is complicated and choosing the wrong option can put you at significant risk of losing control over your choice of providers, specialists, and even your own course of care. On some plans you may have to appeal denied or delayed claims, or pay for care that should be covered.
“I’m covered for any doctor who accepts Medicare under my plan, including top specialists”
This is only true if you have a Medicare Supplement plan. In contrast, Medicare Advantage plans are managed care plans, which means the insurance company determines the network of available doctors and providers and how much you will pay for care if you stay within their network plans—and the network can change at any time and the plans change yearly.
“Medicare Advantage plans are one type of Medicare Supplement.”
This is not true. Medicare Advantage plans (a.k.a. Medicare Part C) are not a type of Medicare Supplement. Instead of supplementing Original Medicare (a.k.a. Medicare Parts A and B), they replace it. In contrast, Medicare Supplement plans (a.k.a. Medigap) are designed to layer on top of Original Medicare. Medicare Advantage and Supplement plans pay for various things Original Medicare doesn’t cover, depending upon which Supplement plan you choose (See this comparison chart).
“Medicare is Free.”
Like most things in life, Medicare isn’t free. The rule of thumb is that as monthly premiums decrease, out of pocket costs tend to increase. With certain types of plans, the more healthcare services you use the more you may pay.
Most Medicare plans are similar
This couldn’t be farther from the truth, especially in the ways that are important to most retirees.
- Freedom of choice:
- Avoid plans that limit on your freedom to choose your own providers, specialists, and course of care.
- Predictable costs:
- Consider plans that account for all potential financial impacts—monthly premiums, deductibles, co-pays, and co-insurance—both now and in the future
- Avoid plans that require referrals or pre-authorizations and plans that may deny legitimate claims
- Find plans with no referrals, pre-authorizations, or claims hassles
- Avoid plans with restrictive provider networks
- Consider a plan that doesn’t change year to year
- Peace of mind:
- Consider plans that are turnkey and cover as much as possible, even if the monthly premiums are higher
“I need to enroll in Part A and B at the same time.”
Not necessarily. You can delay enrollment in Part B, but should enroll in Part A right away.
“My Medicare plan is probably should be the same as my spouse’s.”
Contrary to popular belief, Medicare isn’t often the same for spouses or partners.
“I have to be 65 to enroll in Medicare”
If you meet certain conditions, such as those below, you can enroll any time after your 65th birthday.
- You lose coverage (yours or spouse’s dependent coverage)
- You move outside your plan’s coverage area
- You move back to the U.S.
- You leave jail
Or at any age if:
- You’re eligible for both Medicare and Medicaid
- You’re eligible for a Special Needs Plan
- You’re eligible for Extra Help
- There’s a five-star plan available in your area
Starting your Medicare enrollment journey 5 of 6 months before your 65th birthday gives you time to:
- Understand your options and make an informed choice
- Avoid gaps in coverage
- Coordinate termination of your current coverage Medicare
- Time to change your mind
- Peace of mind: Confidence you’ve made the right decisions
“My parents’ Medicare is my parents’ exclusive decision.”
Not true. Medicare decisions can affect generations. Help your parents research their Medicare options, just as you would help them in a health crisis. Find a qualified Medicare Advisor to help assemble the big picture on their retirement, and a plan to accommodate it.
“Medicare Advisors charge fees to help set up a personalized Medicare plan.”
Not necessarily. Medicare Advisors are specialists who should also be licensed to advise and enroll people in Medicare insurance. They ask questions about your retirement goals, dreams, plans and in general what you want your future to look like. Many do not charge a fee for their services whether or not you enroll with them. Medicare Advisors not only help you choose the right plan, but some help you enroll in the government sponsored Medicare Part A and Part B required to get a Medicare supplement. Advisors will help you find the best fit, not just a plan that any given Medicare agency offers.
About ActivAge Medicare Advisors
We strive to educate and explain the complex options offered by the Medicare system, so our clients can make well-informed decisions about their retirement healthcare. Our emphasis remains on freedom of choice, cost predictability, and personalization:
- Freedom of choice: You and your doctor decide what is best, not an insurance company
- Cost predictability: Not only monthly premiums, but all other out-of-pocket expenses
- Personalization: Matching our clients’ needs with the best available solutions